How to operate the heart despite the chest bone

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What is Heat Bypass Surgery:

Heart bypass surgery, also known as coronary artery bypass grafting (CABG), is a common surgical procedure used to treat coronary heart disease. In traditional methods, the surgery involves creating a bypass around blocked or narrowed coronary arteries to restore blood flow to the heart muscle.

When performing heart bypass surgery in the traditional or “sternotomy” approach, an incision is made along the sternum or breastbone. The sternum is then divided, allowing access to the heart. However, during the procedure, the surgeon may need to make additional incisions or cut through other structures to reach the heart and perform the necessary bypass grafting.

In the context of your question, it seems you are referring to the cutting of the breastbone or sternum during the operation. This process is known as a median sternotomy, and it is a standard approach for accessing the heart during cardiac surgery, including heart bypass surgery.

It’s important to note that advancements in medical technology and surgical techniques may lead to variations in the procedure. Minimally invasive approaches are also becoming more common, where smaller incisions are made, and specialized tools are used to perform the surgery. These approaches aim to reduce the trauma associated with traditional sternotomy and may involve less cutting of surrounding tissues.

What is Traditional Method :

The traditional method of bypass surgery, known as “bypass surgery” (bypass surgery), causes severe pain in the patient’s body, and this pain persists for many days. Additionally, due to this procedure, the patient’s body may have a scar of approximately 13-14 inches.

Alternative Solution:

To address the problem, several alternative methods are currently being utilized. For instance, performing bypass surgery by cutting from the side rather than the front of the chest. This approach significantly reduces the length of the incision (approximately 3.5 inches). Additionally, cutting through the space between two ribs is another method employed during this procedure, which eliminates the need to cut the breastbone.

Minimal Invasive Cardiac Surgery (MICS):

Currently, operations of this nature are being performed with the assistance of Minimal Invasive Cardiac Surgery (MICS), resulting in smaller scars. Furthermore, there is no need to cut the breastbone during these procedures.

In the MICS (Minimal Invasive Cardiac Surgery) approach, a small (2.5 inches) incision is made on the left side wall of the chest, and a laparoscopic probe is used to facilitate the entire bypass surgery. In this method, the left internal mammary artery (LIMA) is initially harvested. Subsequently, using the same incision, grafting of the left anterior descending (LAD) artery is performed. The LAD artery is the vessel responsible for supplying nutrition to the heart muscle.

Benefits of Minimal Invasive Cardiac Surgery (MICS):

1. Reduced Hospital Stay: The use of minimally invasive techniques results in a shorter hospital stay for patients.
2. Less Blood Loss: During minimally invasive procedures, there is less blood loss, allowing patients to recover more quickly.
3. Avoidance of Breastbone Incision: There is no need to cut the breastbone during minimally invasive surgery, leading to reduced pain and quicker recovery.
4. Comparable Effectiveness: This method often yields outcomes that are as good as or even better than traditional open-heart surgery without opening up significant portions of the heart.
5. Lower Risk of Infection: The likelihood of infection is significantly reduced with minimally invasive approaches.
6. Freedom from a Central Chest Scar: Patients undergoing this procedure are spared from a central chest scar. This is particularly significant for individuals, including women, who prefer not to have a lifelong scar in the middle of their chest.

It’s important to note that the information provided is a general overview, and individual cases may vary. Consultation with a healthcare professional is essential for personalized advice and information regarding specific medical conditions.

In various fields, this method is being regularly employed in different types of minimally invasive surgeries. It is effectively utilized in procedures such as mitral valve replacement and closing holes in the heart. Nowadays, even larger-scale cardiac surgeries, akin to bypass surgery, are easily performed with minimal incisions or smaller openings.

Writer:-Dr. Lalit Kapoor